| NPI | 1023695004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TUSHONDA FLEETON BOYD Owner 228-760-0262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2023-03-27 |